發(fā)布時間：2018-10-23 12:20

【摘要】：目的:探究頸椎病病人接受頸后路單開門椎管擴大成形手術(shù)之后頸5神經(jīng)根麻痹的風(fēng)險因素。方法:收集山西醫(yī)科大學(xué)第二臨床醫(yī)院骨科2011年3月至2014年3月期間96例接受頸后路單開門椎管擴大成形術(shù)的頸椎病病人。收集病人的醫(yī)療記錄、影像數(shù)據(jù),以及術(shù)后復(fù)查資料�；颊呷朐汉缶蓄i椎X線、頸椎CT以及頸椎MRI檢查,擇期接受頸后路單開門椎管擴大成形手術(shù)治療,術(shù)后給予營養(yǎng)神經(jīng)、補液、消炎消腫等對癥治療并密切觀察病情變化。對患者影像學(xué)資料進行分析,提取數(shù)據(jù):頸椎曲度指數(shù),頸5椎間孔寬度,上關(guān)節(jié)突的位置。將出現(xiàn)頸5神經(jīng)根麻痹病例與沒有出現(xiàn)的病例分組,比較兩組因素數(shù)據(jù)。應(yīng)用統(tǒng)計學(xué)回歸研究方法,評估頸5神經(jīng)根麻痹的危險因素。結(jié)果:本研究項目共計96例接受頸后路單開門椎管擴大成形術(shù)的病人資料,其中7例出現(xiàn)頸5神經(jīng)根麻痹,89例無頸5神經(jīng)根麻痹。頸5神經(jīng)根麻痹出現(xiàn)概率為7.3%。麻痹組與無麻痹組在頸5椎間孔寬度,以及上關(guān)節(jié)突向前位移的差異有統(tǒng)計學(xué)意義。logistic回歸統(tǒng)計研究結(jié)論表明第一、二、三區(qū)間C5神經(jīng)根麻痹的風(fēng)險分別增加66.140(95%CI,4.811—908.857)、8.147(95%CI,0.575—115.141)及3.554倍(95%CI,0.154—80.861)。結(jié)論:術(shù)前C5椎間孔狹窄為頸后路單開門椎管擴大成形術(shù)后C5神經(jīng)根麻痹的重要危險因素。
[Abstract]:Objective: to investigate the risk factors of cervical 5 nerve root paralysis in patients with cervical spondylosis after open door spinal canal reconstruction. Methods: from March 2011 to March 2014 96 patients with cervical spondylopathy underwent open door laminoplasty were collected from Department of Orthopaedics of the second Clinical Hospital of Shanxi Medical University. Collect patient's medical records, imaging data, and postoperative review data. After admission, all patients underwent X-ray examination, cervical spine CT and cervical MRI examination. The patients were treated with open door spinal canal enlargement surgery via posterior cervical approach. The patients were treated with nutritional nerve, fluid replacement, anti-inflammatory and swelling treatment, and the changes of the disease were observed closely. The imaging data of the patients were analyzed, and the cervical curvature index, the width of intervertebral foramen and the position of the upper articular process were extracted. The patients with cervical 5 nerve root paralysis were divided into two groups. The risk factors of cervical 5 nerve root paralysis were evaluated by statistical regression method. Results: a total of 96 patients underwent open door laminoplasty via posterior cervical approach, of which 7 had cervical 5 nerve root paralysis and 89 had no cervical 5 nerve root paralysis. The probability of occurrence of cervical 5 nerve root paralysis was 7.3. There were significant differences in the width of intervertebral foramen and the forward displacement of the upper articular process between the paralytic group and the non-paralyzed group. The risk of nerve root palsy increased by 66.140 (95CI 4.811-908.857), 8.147 (95CI0.575-115.141) and 3.554 times (95CI0.154-80.861), respectively. Conclusion: preoperative stenosis of intervertebral foramen is an important risk factor for C5 nerve root palsy after open door laminoplasty.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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本文編號：2289217